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Systemic Lupus Erythematosus in Children

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, that mainly affects skin, joints and kidneys but can affect any organ in the body. It is characterized by presence of multiple autoantibodies like ANA, antibodies to dsDNA and RNA associated proteins. The major mechanism leading to tissue damage includes immune complex mediated complement activation, interferon alpha release by plasmacytoid dendritic cells, NETosis by neutrophils as well as defects in monocytes leading to poor clearance of cellular debris and direct cellular dysfunction mediated by antibodies. A child can present with pyrexia of unknown origin, immune mediated cytopenias, malar rash, oral ulcers, serositis, glomerulonephritis or nervous system dysfunction. As renal disease has a bearing on the long term impact, all children should have urine exam and blood pressure measurement done to rule out renal disease. The treatment varies depending on the severity and organs involved. In life or organ threatening situations, pulse methylprednisolone is used. Hydroxychloroquine, Mycophenolate mofetil, Azathioprine and Cyclophosphamide are the commonly used drugs in SLE. Over the years the prognosis of SLE has improved probably due to early diagnosis and better use of immunosuppressive treatment, regular follow up and treatment of co-morbidities. The 10-year survival now approaches 90% and with advent of new and targeted therapy it is hoped that the morbidity and organ damage can also be minimized.

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Authors and Affiliations

  1. Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India

    Kunal Chandwar & Amita Aggarwal

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  1. Kunal Chandwar
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  2. Amita Aggarwal
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KC: Data collection, first draft of article, revision and final approval of the article. AA: Critical review, revision of the article and final approval of the article. AA will act as guarantor for this paper.

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Correspondence to Amita Aggarwal.

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Chandwar, K., Aggarwal, A. Systemic Lupus Erythematosus in Children. Indian J Pediatr (2023). https://doi.org/10.1007/s12098-023-04833-0

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